Surgical Equipment: PREOP, OR, PACU

Summary

This module explores the surgical environment, focusing on the OR layout and the daily workflow of surgical staff. It follows Mary, a surgical technologist, and Tom, a surgical nurse, through their day, detailing their preparation in locker rooms, activities in the lounge, and responsibilities in the OR. The script highlights the importance of maintaining sterility, the setup of equipment, and the flow of patients from pre-op to PACU. It emphasizes the one-way path to prevent contamination and the role of each staff member in ensuring a safe and efficient surgical process.

Takeaways

• 🏥 The module focuses on the layout of pre-op, PACU, and the OR, and the daily workflow of surgical staff.
• 👔 Surgical technologists and nurses start their day by changing into hospital-issued scrubs in the locker rooms.
• 🍽️ The OR lounge is a semi-restricted area where staff can eat and take breaks before entering the OR.
• 🛂 The control desk is where staff receive their daily assignments and participate in morning huddles.
• 🚪 The outer hallway is a high-traffic area where various medical professionals and patients move between different areas.
• 🏠 Each OR room is equipped with specific equipment tailored to the procedures performed there.
• 🔄 The inner core is where sterile supplies and case carts are stored for quick access during surgeries.
• 👩‍⚕️ Surgical technologists set up sterile fields and prepare for procedures, while nurses manage patient care.
• 🛡️ Once a patient enters the OR, all opened instruments and supplies are considered contaminated.
• 🧼 Dirty instruments and supplies must be covered and taken to decontamination, avoiding contact with sterile areas.
• 🔁 The process is repeated throughout the day, with strict adherence to a one-way path to maintain sterility.

Q & A

What is the first location Mary and Tom visit in the hospital?

Mary and Tom start their day in the male and female locker rooms, where they change from their street clothes into surgical hospital-issued clothes.

What items of clothing do Mary and Tom change into after entering the locker rooms?

After changing, Mary and Tom wear surgical scrubs, hair covers, and shoe covers.

What is the purpose of the OR lounge?

The OR lounge is a semi-restricted area where staff can eat and take their breaks before entering the operating room.

What is the significance of the outer hallway in the OR suite?

The outer hallway is where a lot of activity takes place, including the movement of surgeons, anesthesiologists, surgical techs, and other staff, as well as the transportation of patients to their rooms.

Why is wearing a mask required when leaving the OR lounge?

A mask is required when leaving the OR lounge because it leads to the outer hallway and restricted areas where there is increased potential for microbial exposure.

What is the role of the control desk in the OR suite?

The control desk is where the schedule for the day is managed, and staff members can see their assignments for the day. It is also a place for morning huddles where managers discuss important issues.

How are the OR rooms equipped for different surgical procedures?

Different OR rooms are equipped with specific equipment based on the type of procedures scheduled for that day. For example, one room might be dedicated for cystoscopy, while others might be for orthopedic or cardiac surgeries.

What is the inner core and why is it important?

The inner core is an area filled with prepared case carts for the day's surgeries, as well as shelves of extra sterile supplies for quick access during procedures. It is important to keep the sterile supplies separate from potential contaminants.

What is the role of the surgical technologist and nurse in setting up for a surgical procedure?

The surgical technologist and nurse are responsible for collecting the necessary equipment, setting up the sterile field, and preparing the case carts with all the supplies needed for the specific procedure.

Why is it crucial to keep the OR doors closed during surgeries?

The OR doors should be kept closed to minimize the movement of microbes that can be stirred up by the traffic of people in the outer hallway. This helps maintain a sterile environment within the OR.

What happens to the instruments and supplies after a patient enters the OR room?

Once a patient enters the OR room, all opened instrumentation and supplies are considered contaminated with the patient's microbes. They cannot be taken into areas with sterile supplies and must be covered and taken to the surgical decontamination room.

Outlines

00:00

🏥 Overview of the Operating Room Environment

This paragraph introduces Module 4, focusing on the surgical equipment and layout of the pre-op, PACU, and the OR itself. It discusses the roles of CSPD and their responsibilities in the OR, and then transitions to a day in the life of a surgical technologist, Mary, and a surgical nurse, Tom. Their routine starts in the locker rooms, changing into hospital-issued surgical attire before proceeding to the OR lounge, a semi-restricted area for staff breaks. The paragraph also describes the outer hallway as a bustling area for various medical professionals and the process of bringing patients into the OR. It emphasizes the importance of wearing masks once entering the restricted area outside the lounge.

05:02

🛠️ OR Setup and Patient Flow

The second paragraph delves into the OR setup, detailing the process of Mary and Tom preparing for surgery. It explains the role of the control desk for scheduling and assignments, and the morning huddle for discussing the day's important issues. The paragraph outlines the OR room setup, including the presence of specific equipment like towers and cameras depending on the type of procedures scheduled. It also describes the process of collecting necessary equipment for surgeries and the importance of the inner core for storing and accessing sterile supplies. The patient flow is also discussed, from pre-op to the OR and then to PACU, with an emphasis on maintaining sterility and cleanliness by treating all opened supplies and instruments as contaminated once the patient enters the OR.

10:04

🧼 Post-Procedure Cleanup and Sterility Maintenance

The final paragraph discusses the post-surgical procedures, including the cleanup of the OR by Mary and the transport of the patient to PACU by Tom. It highlights the importance of not bringing dirty instruments or supplies back into sterile areas to prevent cross-contamination. The paragraph also touches on the cleaning process of the OR by housekeeping, which involves specific methods and new cleaning materials for each room. The narrative concludes with the anticipation of the next module, which will further explore the OR Suite and the intraoperative process.

Keywords

💡Pre-op

Pre-op refers to the preparation phase before surgery. It is where patients undergo a series of checks, including consent verification and ID confirmation, as described in the video when Tom prepares the patient for surgery. This stage ensures all procedures are confirmed before the operation begins.

💡PACU

PACU stands for Post-Anesthesia Care Unit, where patients are taken after surgery to recover from anesthesia. The video mentions Tom bringing the patient back to PACU after the procedure, highlighting its role in monitoring patient recovery post-surgery.

💡Surgical Technologist

A surgical technologist is a key healthcare professional in the operating room who prepares the equipment and sterile field for surgeries. In the video, Mary is the surgical technologist, responsible for setting up supplies and ensuring that all equipment is ready for the operation.

💡Sterile Supplies

Sterile supplies refer to medical instruments and materials that have been sterilized to prevent infection during surgery. The video discusses how Mary retrieves sterile supplies from the inner core to set up for the operation, emphasizing the importance of maintaining sterility in the OR.

💡Case Cart

A case cart is a trolley containing all the necessary sterile instruments and supplies for a specific surgical procedure. The video shows Mary collecting the case cart for the day’s first surgery, demonstrating how hospitals organize supplies for specific procedures in advance.

💡Inner Core

The inner core is a designated storage area within the operating room complex where sterile supplies and case carts are stored. The video illustrates how Mary retrieves supplies from the inner core, showing how it helps ensure quick access to sterile items during surgery.

💡Restricted Area

Restricted areas in the hospital, particularly in the OR, are zones where special precautions, such as wearing masks, are necessary to maintain sterility. The video mentions that Mary and Tom enter restricted areas after changing into scrubs, highlighting how these areas are controlled to prevent contamination.

💡Environmental Services

Environmental services refer to the hospital staff responsible for cleaning and maintaining the sterility of operating rooms. The video explains that after surgery, environmental services clean the OR using specific methods, ensuring that each room is sterile for the next procedure.

💡Control Desk

The control desk is a central point in the operating room area where staff receive assignments and discuss the daily schedule. The video describes how Mary and Tom check in at the control desk to see where they are assigned for the day, making it crucial for workflow management in the OR.

💡Microorganisms

Microorganisms, or microbes, are tiny organisms such as bacteria that can cause infection if introduced into a sterile environment. The video emphasizes the importance of limiting traffic in certain areas to prevent stirring up microorganisms, which could contaminate the sterile environment of the OR.

Highlights

Introduction to Module 4 focusing on surgical equipment and layout of pre-op, PACU, and the OR.

Exploration of the flow of a typical day in the operating room through the activities of surgical technologist Mary and surgical nurse Tom.

Description of the unrestricted male and female locker rooms where staff change into surgical attire.

Explanation of the OR lounge as a semi-restricted area for staff meals and breaks.

Importance of the outer hallway as a high-traffic area for various surgical roles and patient transport.

Requirement of wearing masks when entering the outer restricted area from the lounge.

Role of the control desk for managing the daily schedule and staff assignments.

Process of collecting equipment needed for specific surgical procedures like knee scopes.

Differentiation of equipment in various OR rooms based on the type of procedures performed.

Mary's responsibility for setting up the sterile field and Tom's for patient transport from pre-op.

Pre-op procedures including checking consents, ID bands, and patient confirmation.

Importance of keeping OR doors closed to minimize microbial spread from high traffic.

Description of the post-surgery process including cleaning the sterile field and patient transfer to PACU.

Concept that once a patient enters the OR, all opened instrumentation and supplies are considered contaminated.

Procedure for handling dirty instruments and supplies, ensuring they do not re-enter sterile areas.

Housekeeping's role in cleaning and turning over the OR room using specific methods after each surgery.

Mary's routine of finding the next case cart and repeating the process until all scheduled cases are completed.

Teaser for the next module, which will delve into further details of the OR Suite and intraoperative processes.

Transcripts

hello welcome to module 4 surgical

equipment

um in this module we're going to go over

the layout of pre-op pacu and um the or

itself

last module we took a closer look at

cspd and their important

responsibilities in the OR

this week we're going to take a look at

the or room itself

um pre-op and pacu I want you to see

kind of the flow of how a typical day

will go in the operating room

so how we're going to do this is we're

going to pretend to follow

um a surgical technologist Mary and a

surgical nurse Tom through a typical day

in the operating room

Mary and Tom will start their day in the

male and female locker rooms

um

located right here okay we already

discussed that these are unrestricted

areas

Mary and Tom go into the locker rooms

um in their street clothes and change

into surgical hospital-issued surgical

clothes

um paps and shoe covers

um now

after they change into their scrubs and

haircut hair cover and shoe covers

they'll go into the next access is the

or lounge

um this Lounge is another

semi-restricted area where staff can eat

and take their breaks

uh the or will be through doors

about you know somewhere around here

um and leads to this outer hallway and

if you remember that outer hallway from

the last slide

is where man a lot of a lot of stuff

happens in that outer hallway this is

sturgeons anesthesiologists surgical

techs operating room patient care

technicians Transporters x-ray

technicians surgical assistance position

assistance

there's a lot of traffic in these areas

okay this is also how nurses will bring

the patients into their individual rooms

so Mary and Tom they've changed they've

went to the lounge now they've walked

into this outer

um uh restricted area which a mask will

be required

um so before they leave that Lounge you

don't need a mask in the lounge but once

you leave that Lounge you should have a

mask on

um they start their day by heading over

to the control desk okay this is one

area where there will be someone in

charge who handles the schedule for the

day this is also where each staff member

can see where they are assigned for the

day

after receiving their assignment

sometimes they'll also have a morning

huddle where the the managers will

discuss any important issues for the day

or maybe cases that have to be turned

over quickly

um but so after that happens Mary and

Tom head off to their assigned or room

so here in this particular or we have 10

rooms okay one is hidden right there you

can't see it two three four five six

seven eight nine ten

um depending on the schedule for that

room and the type of procedures that

will be done for that day different

types of equipment will be needed often

in hospitals you'll see one room that's

dedicated for Sisto and two rooms that

are dedicated for Ortho and then you'll

have two heart rooms

um and so on and so forth okay each of

those rooms will have specific equipment

as you can see over here in this picture

this room has a tower this Tower

includes a camera you can see a monitor

here a light cord this could be where

Scopes are done so that that does that

lives in that room and that wouldn't

have to be brought in and out if you're

in a different room that doesn't have

that equipment and let's say you're

doing a knee scope

um then this is the time where Mary and

Tom are going to start collecting all of

that equipment that they may need for

their for those knee Scopes things like

positioners bags bags of fluid cameras

light cords monitors

um if they were in a guinea room or

gynecological room they'd have

completely different equipment okay

after the team assures that the

equipment is ready for the day

Mary then heads to the inner core where

her supplies are located this is that

case cart that we talked about last week

and so this inner core

um

is filled with prepared case carts for

the cases of the day the first cases of

the day

um these case cards have all the

supplies needed for your specific

procedure there's also going to be

within this inner core shelves of extra

sterile supplies and they'll be kept

there for quick access during the

surgical procedures so that we don't

have to wait for cspd to bring something

we can uh circulator can run into the

inner core and grab some extra gloves or

sponges if they need them

um okay so Mary finds her first case

cart of the day she brings it into room

five and the team begins to open and set

up the sterile supplies

while Mary continues to open and prep

the sterile field Tom is going to go to

get

um the patient in pre-op okay pre-op

will be connected to the operating room

um this is where he's going to complete

his pre-op routine this is going to be

checking consents checking the ID band

making sure that you have the correct

patient making sure that confirming

which side is to be done if this is a

specific side surgery

after hit the pre-op routines are done

Tom will transport the patient on a cart

back to the or is coming back and he's

going to go through that outer hallway

again and through outer doors into room

five now all of these or door or Suites

also have doors into the inner core okay

now we talked about there being a lot of

traffic here

we want to keep these doors closed as

much as possible due to that extreme

amount of traffic

I want you to think about microbes if

you have a lot of people

um walking around in those areas that's

going to stir up

microorganisms the more people the more

microbes

um

okay so Tom brings our patient back to

room five uh and this is where that

surgical procedure is going to be

completed

after the procedure is complete Mary

begins to clean up the sterile field

while Tom brings the patient back to

pacu now remember pacu is that post

anesthesia Care Unit

um so again he is going to bring out

these outside doors to this outer

hallway

and then into pacu

okay

um

now an important note once the patient

has entered that or room so we brought

that patient into the OR

all of the opened instrumentation and

supplies are considered dirty or

contaminated with the patient's microbes

okay that patient comes into the room

without a mask breathing on their skin

they have specific microbes and once

they enter there we are considering

everything in that room dirty

once instruments and supplies are dirty

they cannot enter an area with sterile

supplies such as another or the inner

core so I couldn't take instruments here

and walk through the inner core

or go into another room carrying a dirty

instrument that means we're transferring

that microbe into multiple clean and

sterile areas

the dirty supplies must be covered taken

through the outer hallway

which does not hold sterile supplies and

then taken to the surgical

decontamination room

during and you'll remember it was over

in this area here

during this time housekeeping or

environmental services will be called to

clean or turn over our room five

specific cleaning methods are used which

include new mops and Rags for each dirty

room

after the room is appropriately cleaned

Mary looks for her next case cart and

repeats the process until the scheduled

cases are done for the day

you can see that same circular path that

we discussed in cspd the path is the one

way you're never going to bring those

dirty instruments back into a sterile or

Okay

um it has to go

um that dirty the dirty instruments and

dirty supplies have to go into decontam

directly and not go into even a clean

elevator

the path is one way so that that dirty

is never brought into clean during the

next module we're going to go into

further detail of the or Suite itself

um and then we're gonna see exactly what

goes on during that intraoperative

process